A metabolomics approach for predicting the response to intravenous iron therapy in peritoneal dialysis patients with anemia

Anemia is an almost universal complication of chronic kidney disease (CKD), and nearly all patients with end-stage renal disease (ESRD) and approximately 70% of those with earlier stages of CKD receive treatment for anemia.

Download Full-text

Investigation of the Impact of Endodontic Therapy on Survival among Dialysis Patients in Taiwan: A Nationwide Population-Based Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010326 ◽

2021 ◽

Vol 18 (1) ◽

pp. 326

Author(s):

Chih-Chien Chiu ◽

Ya-Chieh Chang ◽

Ren-Yeong Huang ◽

Jenq-Shyong Chan ◽

Chi-Hsiang Chung ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Root Canal ◽

Dialysis Patients ◽

Root Canal Therapy ◽

Risk Of Death ◽

Stage Renal Disease ◽

End Stage

Objectives Dental problems occur widely in patients with chronic kidney disease (CKD) and may increase comorbidities. Root canal therapy (RCT) is a common procedure for advanced decayed caries with pulp inflammation and root canals. However, end-stage renal disease (ESRD) patients are considered to have a higher risk of potentially life-threatening infections after treatment and might fail to receive satisfactory dental care such as RCT. We investigated whether appropriate intervention for dental problems had a potential impact among dialysis patients. Design Men and women who began maintenance dialysis (hemodialysis or peritoneal dialysis) between January 1, 2000, and December 31, 2015, in Taiwan (total 12,454 patients) were enrolled in this study. Participants were followed up from the first reported dialysis date to the date of death or end of dialysis by December 31, 2015. Setting Data collection was conducted in Taiwan. Results A total of 2633 and 9821 patients were classified into the RCT and non-RCT groups, respectively. From the data of Taiwan’s National Health Insurance, a total of 5,092,734 teeth received RCT from 2000 to 2015. Then, a total of 12,454 patients were followed within the 16 years, and 4030 patients passed away. The results showed that members of the non-RCT group (34.93%) had a higher mortality rate than those of the RCT group (22.79%; p = 0.001). The multivariate-adjusted hazard ratio for the risk of death was 0.69 (RCT vs. non-RCT; p = 0.001). Conclusions This study suggested that patients who had received RCT had a relatively lower risk of death among dialysis patients. Infectious diseases had a significant role in mortality among dialysis patients with non-RCT. Appropriate interventions for dental problems may increase survival among dialysis patients. Abbreviations: CKD = chronic kidney disease, ESRD = end-stage renal disease, RCT = root canal therapy.

Download Full-text

Diálise Peritoneal nos Dois Primeiros Anos de Vida: Experiência de uma Unidade de Nefrologia e Transplantação Renal Pediátrica

Acta Médica Portuguesa ◽

10.20344/amp.6913 ◽

2016 ◽

Vol 29 (9) ◽

pp. 525

Author(s):

Sofia Deuchande ◽

Tânia Mano ◽

Cristina Novais ◽

Rute Machado ◽

Rosário Stone ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Renal Transplantation ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Term Survival ◽

Stage Renal Disease ◽

End Stage

Introduction: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purposewas to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life.Material and Methods: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated.Results: Twenty children started peritoneal dialysis within the first two years of life. There were six deaths, but no deaths of children with primary chronic kidney disease were registered over the past decade. The 14 living children were characterized; 13 were males. Congenital abnormalities of the kidney and urinary tract were the leading etiology of chronic kidney disease (45%). The average age start of peritoneal dialysis was 6.1 months; six children started before 30 days of life. Peritonitis was the most frequent cause of hospitalization. Ten children were transplanted at an average age of 5.3 years. All of the children who are still in peritoneal dialysis have short stature, but nine of the transplanted have final height within the expected for their mid-parental height target range. Nine (64%)had some type of neurodevelopmental delay.Discussion: Peritoneal dialysis is a technique possible and feasible since birth, as evidenced in the study, as more than half of children successfully started it before 6 months of life. It allows long-term survival until the possibility of renal transplantation despite the associated morbidity, including peritonitis and complications of chronic renal disease. The ten transplanted children improved their growth, recovered from chronic anemia and improved dyslipidemia, compared with the period of dialysis. However, the average waiting time until the renal transplant was 5.3 years higher than other international centers.Conclusion: These data support the use of peritoneal dialysis from birth, but complications and the worst growth reflect the need to develop strategies to optimize care relating to nutrition, growth and development and to reduce pre-transplant time.

Download Full-text

Preoperative Evaluation in Patients With End-Stage Renal Disease and Chronic Kidney Disease

Health Services Insights ◽

10.1177/1178632917713020 ◽

2017 ◽

Vol 10 ◽

pp. 117863291771302 ◽

Cited By ~ 2

Author(s):

Rabih Nasr ◽

Sridhar Chilimuri

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Preoperative Evaluation ◽

Dialysis Session ◽

Dialysis Access ◽

Dialysis Patients ◽

Stage Renal Disease ◽

End Stage

Optimal preoperative management of dialysis patients remains challenging. Patients with end-stage renal disease (ESRD) have higher mortality in the perioperative setting compared with non-ESRD patients. However, it is well established that dialysis should be done on the day before surgery. Additional dialysis session prior to surgery does not improve outcomes. All dialysis patients should undergo blood work to check electrolytes and especially serum potassium prior to any surgery. Some medications, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics, should be stopped prior to surgery to minimize hemodynamic changes during surgery. The dialysis access should be carefully examined for any signs of infection. The arteriovenous fistula or graft should be evaluated for patency. Glycemic control in diabetic ESRD and chronic kidney disease patients is very important, and clinicians should be aware of the risk of bleeding and the appropriate analgesics that can be used in dialysis patients in the perioperative setting. In conclusion, preoperative evaluation in patients with ESRD should be a multidisciplinary approach.

Download Full-text

Prevalence of end stage renal disease in diabetic obese and hypertensive patients and cardiovascular risk in dialysis patients

Pakistan Journal of Pharmaceutical Research ◽

10.22200/pjpr.2016142-48 ◽

2016 ◽

Vol 2 (1) ◽

pp. 42 ◽

Cited By ~ 2

Author(s):

Muhammad Hanif ◽

Hina Javed ◽

Umair Jallani ◽

Nazar Muhammad Ranjha

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Kidney Stone ◽

Cardiovascular Risks ◽

Dialysis Patients ◽

Hypertensive Patients ◽

Stage Renal Disease ◽

End Stage

Chronic kidney disease(CKD) is the cause of irreversible detoriation of renal function which leads to end stage renal disease(ESRD).incidence of end stage renal disease has increased dramatically during last 30 years and screening for early stages of chronic kidney disease is often suggested as preventive measure.the main cause of end stage renal disease are diabetes, high blood pressure,hyperlipidemia and obesity.obesity and increased BMI are the cause of kidney stone and chronic kidney disease.this reports aim to determine the prevalance of end stage renal disease in diabetic obese individuals and other problems that are more likely to be encountered in the end stage renal disease are cardiovascular risks in dialysis patients.GFR and creatinine clearance are used as the major diagnostic tool to determined the kidney function. calcium level is also used as predictive factor to determine the vascular calcification.

Download Full-text

Successful Treatment of Calciphylaxis in a Young Female With End-Stage Renal Disease on Peritoneal Dialysis With Parathyroidectomy, Intensification of Dialysis, and Sodium Thiosulphate—A Case Report and Literature Review

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/23247096211060580 ◽

2021 ◽

Vol 9 ◽

pp. 232470962110605

Author(s):

Sasmit Roy ◽

Sohil Narasimha Reddy ◽

Amarinder Singh Garcha ◽

Praveena Vantipalli ◽

Sumit S Patel ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Young Female ◽

The Body ◽

Sodium Thiosulphate ◽

Stage Renal Disease ◽

End Stage

Calcific uremic arteriolopathy, commonly referred to as “calciphylaxis,” is a rare life-threatening condition observed in patients with chronic kidney disease and end-stage renal disease on dialysis. This results in necrotic, ischemic, tender dermal lesions anywhere in the body, but mainly on the abdominal wall and lower extremities, where subcutaneous tissue is abundant. Histologically, it is defined by calcification in dermal capillaries, arterioles, and subcutaneous adipose tissues. It can occur in all advanced stages of chronic kidney disease as well as end-stage renal disease patients on hemodialysis or peritoneal dialysis. Our case highlights a successful case of calciphylaxis in a young female patient who underwent parathyroidectomy and intensification of peritoneal dialysis regimen along with the infusion of sodium thiosulphate injection resulting in complete resolution of the lesion in 3 months. With limited evidence of treatment options and increased frequency of this condition in a dialysis patient, our case highlights the key aspects of calciphylaxis management in a young end-stage renal disease patient who didn’t need a change of dialysis modality. We also review the risk factors and current practiced management options of this condition in our article.

Download Full-text

The Continuum of Chronic Kidney Disease and End-Stage Renal Disease: Challenges and Opportunities for Chronic Peritoneal Dialysis in the United States

Peritoneal Dialysis International ◽

10.1177/089686080702700204 ◽

2007 ◽

Vol 27 (2) ◽

pp. 125-130 ◽

Cited By ~ 9

Author(s):

Rajnish Mehrotra

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Chronic Peritoneal Dialysis ◽

The Usa ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End-stage renal disease (ESRD) patients undergoing renal replacement therapy have a high mortality rate and suffer from considerable morbidity. Degree of nutritional decline, disordered mineral metabolism, and vascular calcification are some of the abnormalities that predict an adverse outcome for ESRD patients. All these abnormalities begin early during the course of chronic kidney disease (CKD), long before the need for maintenance dialysis. Thus, CKD represents a continuum of metabolic and vascular abnormalities. Treatment of these abnormalities early during the course of CKD and a timely initiation of dialysis have the potential of improving patient outcomes. However, the thesis that successful management of these abnormalities will favorably modify the outcomes of dialysis patients remains untested. The proportion of incident USA ESRD patients starting chronic peritoneal dialysis (CPD) has historically been low. Limited physician training and inadequate predialysis patient education appear to underlie the low CPD take-on in the USA. Furthermore, two key changes have occurred in the USA: steep decline in CPD take-on and progressive increase in the use of automated peritoneal dialysis. The decline in CPD take-on has afflicted virtually every subgroup examined and has occurred, paradoxically, when the CPD outcomes in the country have improved. Understanding the reasons for historically low CPD take-on and recent steep declines in utilization may allow the development of plans to reverse these trends.

Download Full-text

Erythropoietin dose and survival of hemodialysis patients

Biomedical Research and Therapy ◽

10.15419/bmrat.v4i7.195 ◽

2017 ◽

Vol 4 (07) ◽

pp. 1432

Author(s):

Mahdi Mohammadian ◽

Hamid Salehiniya ◽

Salman Khazaei ◽

Abdollah Mohammadian-Hafshejani

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Kidney Function ◽

End Stage Renal Disease ◽

Hemodialysis Patients ◽

Major Health Problem ◽

Major Health ◽

Stage Renal Disease ◽

End Stage

Chronic kidney disease (CKD) is known as a major health problem worldwide (Levey et al., 2007). The CKD is defined as a stage of disease in which the patient's kidney function is less than a half of normal capacity (2). If the kidney function is 10% to 15% less than the normal capacity, the patient has reached the End Stage Renal Disease (ESRD). At this stage, the kidney transplant or dialysis with hemodialysis or peritoneal dialysis is necessary for patient's survival (Levey et al., 2002).

Download Full-text